Postprandial colonic transit and motor activity in chronic constipation

Bazzocchi, Gabriele; Ellis, Jonathan; Villanueva‐Meyer, Javier; Jing, Jennie; Reddy, S. N.; Mena, I.; Snape, William J.

doi:10.1016/0016-5085(90)90289-d

Cited by 161 publications

(112 citation statements)

References 18 publications

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“…In studies combining the conventional manometry with scintigraphic assessment of bolus movements, it has been demonstrated that colonic propulsion is relatively infrequent (only 30% of propagating sequences are propulsive) and is associated with propagating sequences originating in the more proximal part of the colon, which have a higher amplitude and lower velocity of propagation (Cook et al, 2000). In studies focusing on the pre-and postprandial period, it has been observed that before the meal, the presence of simultaneous sequences associates with almost no movement of colonic contents (Bazzocchi et al, 1990). During the first 30 minutes after the meal, the presence of simultaneous and retrograde sequences in the sigmoid colon is associated with movement of colonic contents in retrograde direction (Bazzocchi et al, 1990).…”

Section: Invasive Methodologiesmentioning

confidence: 99%

“…In studies focusing on the pre-and postprandial period, it has been observed that before the meal, the presence of simultaneous sequences associates with almost no movement of colonic contents (Bazzocchi et al, 1990). During the first 30 minutes after the meal, the presence of simultaneous and retrograde sequences in the sigmoid colon is associated with movement of colonic contents in retrograde direction (Bazzocchi et al, 1990). After this period, the colonic contents move both in anterograde and retrograde direction until the occurrence of the high-amplitude propagating sequences, which normally move the majority of colonic contents from the proximal part (transverse) to the distal colon, inducing the sensation and, in a next step, the activation of defecation (Bazzocchi et al, 1990;Herbst et al, 1997).…”

Section: Invasive Methodologiesmentioning

confidence: 99%

“…During the first 30 minutes after the meal, the presence of simultaneous and retrograde sequences in the sigmoid colon is associated with movement of colonic contents in retrograde direction (Bazzocchi et al, 1990). After this period, the colonic contents move both in anterograde and retrograde direction until the occurrence of the high-amplitude propagating sequences, which normally move the majority of colonic contents from the proximal part (transverse) to the distal colon, inducing the sensation and, in a next step, the activation of defecation (Bazzocchi et al, 1990;Herbst et al, 1997). Anterograde and retrograde low-amplitude propagating sequences are believed to play a major role in the mixing function, which allows the colon to absorb water and nutrients and slow the progression of luminal contents (Phillips, 1984).…”

Section: Invasive Methodologiesmentioning

confidence: 99%

“…Anterograde and retrograde low-amplitude propagating sequences are believed to play a major role in the mixing function, which allows the colon to absorb water and nutrients and slow the progression of luminal contents (Phillips, 1984). The increase of both simultaneous and retrograde activity, observed by both conventional and high resolution manometry in the left colon during the postprandial period, has been hypothesized to play a role in facilitating the retrograde transport of colonic contents to the transverse colon, producing the necessary distension to generate high-amplitude propagating sequences occurring later after the meal (Bazzocchi et al, 1990).…”

Section: Invasive Methodologiesmentioning

confidence: 99%

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Exploring gastrointestinal variables affecting drug and formulation behavior: Methodologies, challenges and opportunities

Hens

Corsetti

Spiller

et al. 2017

International Journal of Pharmaceutics

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(2017) Exploring gastrointestinal variables affecting drug and formulation behavior: methodologies, challenges and opportunities. International Journal of Pharmaceutics, 519 (1-2). pp. 79-97. ISSN 1873-3476Access from the University of Nottingham repository: http://eprints.nottingham.ac.uk/39960/1/FinalVersion-Revised-FOR_EPRINTS_1_YEAR_EMBARGO_ELSEVIER.pdf Copyright and reuse:The Nottingham ePrints service makes this work by researchers of the University of Nottingham available open access under the following conditions. This article is made available under the Creative Commons Attribution Non-commercial No Derivatives licence and may be reused according to the conditions of the licence. For more details see: http://creativecommons.org/licenses/by-nc-nd/2.5/ A note on versions:The version presented here may differ from the published version or from the version of record. If you wish to cite this item you are advised to consult the publisher's version. Please see the repository url above for details on accessing the published version and note that access may require a subscription. After oral intake, a drug formulation is challenged by several gastrointestinal (GI) barriers. Complex variables such as pH, GI secretions and GI transit/motility along the GI tract can affect drug release and absorption in a positive or negative way depending on the physicochemical properties of the drug compound (e.g. pH/pKa interplay for ionizable drugs) and/or the formulation characteristics (e.g. pHsensitive coating). In addition, inter-subject variability in characteristics of the GI environment may cause variable drug absorption and systemic drug availability (Riethorst et al., 2015). Determining the median and range for specific GI variables, and understanding how they influence oral drug behavior along the GI tract, will be helpful in the field of drug development. 2The present review provides an overview of different methodologies that can be applied to study physiological variables of the human GI tract and their impact on oral drug absorption in healthy and patient populations. The methodologies have been subdivided into two groups: (i) noninvasive and (ii) invasive methodologies. Although some of the methodologies are more historical than operational, they have been of paramount importance for innovations in drug and formulation development; in addition, they have created the basis for several novel methodologies, leading to an in-depth comprehension of different GI variables: gastric emptying (magnetic resonance imaging (MRI), scintigraphy, acetaminophen absorption technique, ultrasonography, breath test, intraluminal sampling and telemetry), motility (MRI, small intestinal/colonic manometry and telemetry), GI volume changes (MRI and ultrasonography), temperature (telemetry) and GI pH (intraluminal sampling and telemetry). Noninvasive methodologiesa. Scintigraphy Disturbances in the normal movement of food along the GI tract can be associated with abdominal pain, early satiety and nausea. Measurement of GI transit, es...

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Section: Invasive Methodologiesmentioning

confidence: 99%

Section: Invasive Methodologiesmentioning

confidence: 99%

Section: Invasive Methodologiesmentioning

confidence: 99%

Section: Invasive Methodologiesmentioning

confidence: 99%

See 2 more Smart Citations

Exploring gastrointestinal variables affecting drug and formulation behavior: Methodologies, challenges and opportunities

Hens

Corsetti

Spiller

et al. 2017

International Journal of Pharmaceutics

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“…In questi pazienti, sebbene il ritmo diurno sia generalmente conservato, si riscontrano significative riduzioni dell'attività motoria propulsiva del colon e della risposta del colon dopo un pasto e al risveglio mattutino [10,14]. L'inertia coli è causata da alterazioni dei meccanismi di controllo neuro-ormonali della motilità del grosso intestino che determinano la riduzione o la scomparsa delle onde propulsive di grande ampiezza responsabili dei movimenti di massa dei contenuti intestinali [15,16]. Il sistema colinergico enterico svolge un ruolo fondamentale nel regolare l'attività peristaltica stimolando la contrazione spontanea della muscolatura liscia del colon.…”

Section: Introduzioneunclassified

Clinical and economic profile of prucalopride in the treatment of chronic constipation in women

Stanghellini

Eandi

2012

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stinali, di recente autorizzato nei Paesi della Comunità Europea e disponibile anche in Italia per il trattamento della stipsi cronica idiopatica delle donne che non hanno avuto benefici dall'uso di lassativi [2]. LA STIPSI CRONICA IDIOPATICA DefinizioneLa stipsi è una sindrome (disordine plurisintomatico) costituita da molti sintomi suggestivi di disordini intestinali e/o anorettali: non solo ridotto numero di evacuazioni (< 3/ settimana) [3], ma anche difficoltà nell'espellere le feci (straining), flatulenza, feci troppo aride, fastidio addominale, dolore e gonfiore addominale, dolore rettale, sensazione di evacuazione incompleta, sensazione di falsa urgenza all'evacuazione [4]. Le più recenti definizioni di stipsi considerano sia le difficoltà dell'atto di evacuazione riferite dai soggetti affetti, sia alcuni parametri quantizzabili oggettivamente quali la frequenza dell'alvo e il tipo di feci [5,6]. Sulla base dei distur- INTRODUZIONELa stipsi cronica è un disturbo comune difficile da trattare e le opzioni disponibili per i diversi sottogruppi di stipsi sono limitate e nella maggior parte dei casi insoddisfacenti. Le forme più gravi di stipsi cronica spesso richiedono l'uso di lassativi ad alte dosi o il ricorso a terapie invasive, come evacuazioni manuali e clisteri, e talvolta a interventi di resezione del colon, nei casi limite nei quali tutti i rimedi sono inefficaci o causano effetti avversi e la malattia è fortemente inabilitante [1]. L'introduzione di un nuovo farmaco, come prucalopride, attivo nel promuovere il transito intestinale, può contribuire a migliorare la terapia dei pazienti affetti da stipsi cronica idiopatica che non hanno trovato sollievo dalle precedenti terapie con lassativi. In questa rassegna, dopo una breve analisi della fisiopatologia e della terapia farmacologica della stipsi cronica, valuteremo il profilo farmacologico, terapeutico ed economico di prucalopride, nuovo enterocinetico ad azione agonista selettiva sui recettori 5-HT4 inte- Corresponding authorProf. Mario Eandi mario.eandi@unito.it DisclosureIl presente lavoro è stato realizzato grazie a un supporto incondizionato di Shire Italia S.p.A. ABSTRACTChronic constipation is a common disorder, especially in women. Options available for different subgroups of constipation are limited and in most cases unsatisfactory. The most severe forms of chronic constipation often require the use of laxatives in high doses or the use of invasive therapies. The introduction of a new drug, such as prucalopride, active in promoting intestinal transit, can help to improve the therapy of patients with chronic idiopathic constipation who have not found relief from previous treatment with laxatives. In this review, after a brief discussion of pathophysiology and pharmacotherapy of chronic constipation, we evaluate the pharmacological profile, therapeutic and cost of prucalopride, recently authorized in the EU countries and also available in Italy for the treatment of chronic constipation in women who did not benefit from the use of laxatives.

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A 54-Year-Old Woman With Constipation-Predominant Irritable Bowel Syndrome

Lembo

2006

JAMA

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Postprandial colonic transit and motor activity in chronic constipation

Cited by 161 publications

References 18 publications

Exploring gastrointestinal variables affecting drug and formulation behavior: Methodologies, challenges and opportunities

Exploring gastrointestinal variables affecting drug and formulation behavior: Methodologies, challenges and opportunities

Clinical and economic profile of prucalopride in the treatment of chronic constipation in women

A 54-Year-Old Woman With Constipation-Predominant Irritable Bowel Syndrome

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